Shoulders to the Wheel

During the long battle against the budget bill (the Deficit Reduction Act), the home care community fought with tremendous heart. We saw champion efforts by individual providers and beneficiaries who called or met with their members of Congress throughout the country. We witnessed inspired leadership from the state and regional associations and national stakeholder organizations, including patient advocacy organizations. For that, we should be proud.

This effort by the home care community began in late October 2005 and snowballed into a fierce battle as the House-Senate conferees slipped harmful provisions into the budget bill in December, without any public notice or debate in Congress.

There’s no getting around the fact that the bill passed, but only by the narrowest of margins — 51 to 50 in the Senate and 216 to 214 in the House of Representatives. The bill, signed by the president on Feb. 8, deals blows to home care in three areas: The new law changes the rental period for HME capped rental items from 15 to 13 months with mandatory transfer of title; it caps rental for medical oxygen equipment at 36 months, a drastic shift in Medicare oxygen policy; and it freezes home health reimbursements in 2006.

Note that non-invasive positive pressure ventilators (NPPVs) were recently classified as “respiratory assist devices (RADs) with bi-level capability and a backup rate,” which must be paid as capped rental items effective April 1, 2006.

On top of all of these changes, the 2007 budget proposed by President Bush asks Congress to shorten the oxygen cap to 13 months and freeze in-home health payments again. Even though Congress is unlikely to take up controversial Medicare cuts again during this election year, the home care community must be firm and vocal about opposing these additional assaults in the proposed 2007 budget.

The American Association for Homecare will work to repeal these changes in policy for medical oxygen and the traditional capped rental items and defeat the harmful home care provisions proposed in the 2007 budget.

On other fronts, we continue to push for passage of the Hobson-Tanner bill, H.R. 3559, which would take the sting out of some of the restrictive contracting (competitive bidding) elements of the Medicare Modernization Act. AAHomecare is also working on some of the other near-term and long-term issues related to Medicare reimbursement for oxygen.

From here, home care providers and stakeholders must apply the momentum from the budget battle to strengthen and protect home care policy during 2006.

Let’s raise the volume in our communications with members of Congress, both on Capitol Hill and in the districts. Let’s amplify the voice of both providers and beneficiaries and their families; we saw the power of keeping beneficiaries in the loop during the budget battle. All of these issues are about their health, and they deserve to know how policies made in Washington will affect their care.

At press time, AAHomecare’s council and committees were convening meetings to discuss priorities and plans for 2006. More specific action steps will emerge.

As we go forward, remember a few things about our home care community and AAHomecare. More than 100 representatives from providers, state associations and manufacturers volunteer their wisdom and expertise, not to mention their blood and sweat, serving in leadership positions on association councils and committees. You will not find a more dedicated a group of people. We are also fortunate to have so many active and engaged members throughout the industry. This is the heart and soul of this industry.

AAHomecare will continue to refine its direction as needed to best respond to the enormous job it has with the resources available. With our dedicated leaders and members, and a skilled headquarters staff in Washington, we are fortunate. But the success of the industry depends on broad, unified support. Please put your shoulder to the wheel with us and push forward.

Remember, this is an election year. Put support for home care on the agenda in every district across the U.S.

Tom Ryan is chairman of the board of directors of the American Association for Homecare, Alexandria, Va., and CEO of Homecare Concepts in Farmingdale, N.Y. For more information about AAHomecare, call 703/836-6263 or visit www.aahomecare.org.